化痰活血法改善2型糖尿病模型大鼠胰岛素抵抗的作用机制研究  

Study on mechanism of action of promoting blood circulation and dispersing phlegm method in improving insulin resistance of type 2 diabetes rats

作　　者：冯建华[1] 姜国胜[2] 徐云生[3] 郭宝荣[3] 唐天华[2] 温培娥[2] 董保华[4] 

机构地区：[1]山东中医药大学第二附属医院,济南250001 [2]山东省医学科学院基础研究所,济南250001 [3]山东中医药大学附属医院,济南250011 [4]山东中医药大学,济南250014

出　　处：《中华中医药杂志》2009年第8期1014-1019,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.30371788)

摘　　要：目的:研究化痰活血法对2型糖尿病胰岛素抵抗大鼠的影响与作用机制。方法:将健康SD大鼠,随机分为正常对照空白组和造模组,采用刘氏法建立2型糖尿病胰岛素抵抗大鼠模型;模型鼠又随机分成3组,即胰苏灵组、罗格列酮组、模型组,分别于给药后测定血糖、血脂、胰岛素、胰岛素受体数目与结合力,4周后禁食处死大鼠,留取血清并剪取肌肉、肝、脂肪等组织以检测GK、PEPCK以及脂肪组织TNF-αmRNA表达、肌肉组织GLUT-4mRNA表达、肝细胞GK的mRNA表达。结果:胰苏灵在改善胰岛素敏感指数,降糖、降脂、降低FFA等指标方面与罗格列酮未见明显差异(P>0.05),且胰苏灵可减轻大鼠体质量,研究发现T2DM大鼠模型肝GK活性明显低于空白组(P<0.05),脂肪组织TNF-αmRNA的表达水平明显高于对照组(P<0.05),PEPCK的蛋白定量及GLUT4的表达水平明显低于空白组(P<0.05),提示T2DM大鼠IR与与肝葡萄糖激酶活性降低、脂肪源性TNF-αmRNA高表达、PEPCK活性减低及GLUT4的表达降低密切相关。胰苏灵可以提高T2DM大鼠模型肝葡萄糖激酶活性、脂肪源性TNF-αmRNA的表达水平、增加PEPCK的活性和GLUT4的表达,且与对照药罗格列酮效果相当。结论:具有化痰活血功效的中药制剂胰苏灵是通过提高T2DM大鼠模型肝葡萄糖激酶活性、脂肪源性TNF-αmRNA的表达水平、增加PEPCK的活性和GLUT4的表达,达到改善胰岛素抵抗,发挥治疗2型糖尿病作用的。Objective： To study the effects and mechanism of promoting blood circulation and dispersing phlegm in improving insulin resistance of type 2 diabetes rates. Methods： The healthy SD rats were randomly divided into two groups： control group and model group with type 2 diabetes. The model group was randomly divided into three groups： Yisuling group, rosiglitazome group and model group. Blood sugar, blood lipid, insulin, the number and combining force of insulin-receptor were detected after being treated with the drugs. After 4 weeks treatment course, all rats received fasting diet and were sacrificed. The GK, PEPCK, TNF- α expression in adipose tissue, expression level of GLUT 4 in skeletal muscle and expression level of GK in liver cell were detected. Results： The results showed that there were no obvious differences between Yinsuling and Avandia in improving indexes of insulin sensitivity （P〉0.05）. Compared with control group, the GK activity of liver cell, the expression of PEPCK and the expression of GLUT4 in model group decreased significantly （P〈0.05）, and the mRNA expression of TNF- a of fat tissue increased obviously （P〈0.05）.It suggested that the insulin resistance of type 2diabetes rats was correlated to decrease ofglucokinase activity in liver, increase of mRNA expression of TNF- α in fat tissue, decrease of PEPCK activity and expression of GLUT4.Yisuling could improving insulin resistance of type 2diabetes rats and had equivalent effect to rosiglitazome. Conclusions： Yisuling can increase the GLUT4 translocation of skeletal muscle cell, expression level of GK in liver cell, activity of PEPCK and decrease expression level of TNF- α in adipose tissue by promoting blood circulation and dispersing phlegm to treat insulin resistance.

关 键 词：化痰活血法 2型糖尿病胰岛素抵抗 大鼠模型 实验研究 

分 类 号：R259[医药卫生—中西医结合]